Individual provider Active NPI

Carl Matthew Lewenhaupt, ACNPC - AG

  • Acute Care Nurse Practitioner
  • Boston, MA
National Provider Identifier
1851012264
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN2348097 Issued in MA
Practice address
30 Northampton St
Boston, MA 02118-4098
Phone
(617) 433-9601
NPI assigned
Sep 6, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN2348097 MA Primary

Addresses

Primary practice location

30 Northampton St
Boston, MA 02118-4098

Mailing address

30 Northampton St
Boston, MA 02118-4098
Phone (617) 433-9601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230411001957 MA Practitioner - Nurse Practitioner 9234504911 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bostons Community Medical Group IncGroup PAC ID 1355390691, 31 clinicians

Practice addresses (Care Compare)

30 Northampton St
Boston, MA 02118-4098
Phone (617) 433-9601

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2348097MAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Apr 13, 2023 Accepting new patients
Boston'S Community Medical Group, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Apr 13, 2023 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

30 Northampton St
Roxbury, MA 02118
Phone (617) 433-9601

3550 Main St
Ste 101
Springfield, MA 01107
Phone (413) 739-0669

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1851012264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 NORTHAMPTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184098",
            "telephone_number": "617-433-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 NORTHAMPTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184098",
            "telephone_number": "617-433-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWENHAUPT",
        "first_name": "CARL",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "ACNPC - AG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-06",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "RN2348097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.